Granulocytic Sarcoma is an uncommon manifestation of AML that can affect the orbit. A 10 year-old girl presented with a history of 1 day old proptosis (OS). The patient also presented with diplopia in the inferior quadrants OS. No other significant alterations were seen during her ophthalmological exam, with the exception of proptosis (OS). A CT scan displayed an extraconal mass to the left orbit. The mass had a molding contour with minimal bone destruction. A lateral orbitotomy was later performed. Subsequent histopathological examination and immunohistochemistry confirmed the diagnosis of granulocytic sarcoma. The systemic work-up was normal. The patient later underwent chemotherapy plus radiotherapy, and is now free of systemic disease after a 18-month follow-up. Resumo Sarcoma Granulocítico é uma forma incomum da Leucemia Mielóide Aguda e pode acometer a órbita. Apresentamos uma criança de 10 anos, feminina, que apresentou uma história de proptose no olho esquerdo há 1 dia. A paciente também apresentava diplopia on quadrante inferior do olho esquerdo. Não havia outras alterações ao exame clínico. Tomografia Computadorizada da órbita mostrou uma massa extraconal na órbita esquerda, com contornos em “moldura” sem destruição óssea. Foi realizada uma orbitotomia lateral com biópsia do tumor. O exame histopatológico confirmou o diagnóstico de Sarcoma Granulocítico. Exame clínicoradiológico não mostrou doença sistêmica. A paciente foi submetida a tratamento com quimioterapia e radioterapia e está livre de doença sistêmica após 1 ano e meio de seguimento.

Because eyelid ophthalmomyiasis externa is uncommon, it can be confused easily with a hordeolum or chalazion. We report a case of a 28-year-old patient with lower eyelid myiasis simulating a hordeolum. The patient underwent extraction using a simple surgical technique. The extracted worm was a Dermatobia hominis larva. Resumen Porque la oftalmomiasis externa es inusual, esta entidad puede ser confundida fácilmente con un orzuelo ó chalazión. Reportamos un caso de un paciente de 28 años con una miasis del párpado inferior simulando un orzuelo. Utilizando una simple técnica quirúrgica, una larva de Dermatobia hominis fue extraída en este paciente.

Purpose: We report a case of reversible amantadine-induced corneal edema in a patient with Parkinson's disease and early Fuchs' endothelial dystrophy. Methods: Case report of patient managed by the Cornea & External Disease service at Texas Tech University Health Sciences Center. Results: Clinical findings during the course of treatment including visual acuity, slit lamp examination, specular microscopy, and pachymetry are described. Conclusion: Amantadine is known to cause the onset of endothelial dysfunction and visual impairment even after years of treatment. Fortunately, its effects on the cornea have been shown to be mostly reversible in patients with a near normal endothelial count and function. However, more recent evidence suggests the possibility of irreversible edema despite discontinuation of the drug. Therefore, amantadine-induced endothelial dysfunction in a patient with a significantly reduced endothelial count and/or functionality may also lead to irreversible corneal edema and vision loss. For this reason, we suggest a screening examination for endothelial disease prior to initiating amantadine therapy.

Our studies published in 2008 and 2009 found: Phaco/IOL alone provides an effective treatment for patients with cataract coexistent with ocular hypertension or glaucoma when glaucoma drops are no longer adequate. Phaco/IOL alone may provide an effective treatment for patients with ocular hypertension or glaucoma who do not have cataracts when glaucoma drops are no longer adequate. We postulate as to why phaco/ IOL alone lowers IOP in eyes with elevated IOP: The natural lens, as it ages, compresses the trabecular meshwork and canal of Schlemm, and becomes a major cause of ocular hypertension, a precursor to adult glaucoma. Replacing the enlarged natural lens with a thin artificial lens expands the compressed trabecular meshwork and canal of Schlemm, improves their function, and thereby lowers the once elevated IOP.

Purpose: To evaluate visual results and optical coherence tomography (OCT) findings after treatment with a single subretinal dose of bevacizumab in patients with subfoveal choroidal neovascularization (CNV) due to age-related macular degeneration (AMD). Methods: Four eyes of 4 patients with unilateral advanced subfoveal CNV due to AMD, who refused multiple doses of intravitreal bevacizumab, were recluted. All patients had 20/400 or worse visual acuity (VA) in the affected eye and 20/30 or better in the fellow eye. Each patient underwent vitrectomy with a single subretinal injection of bevacizumab (750μg / 0.3ml) and was followed up for one year with complete eye examinations, including fluorescein angiography (FA) and OCT. Results: At the one year follow-up, VA was stable or improved in 100% of eyes. The central macular thickness (CMT) also decreased significantly, with FA demonstrating a considerable reduction in the size of the subretinal neovascular membranes. Conclusions: Our results suggest that a single dose of subretinal bevacizumab is safe, effective and well tolerated, and significantly improved VA and CMT in patients with neovascular AMD. However, further evaluation with longer follow-up and a bigger population is desirable. Resumen Propósito: Evaluar los resultados visuales y de tomografía de coherencia óptica (OCT) luego de tratamiento con una única dosis de bevacizumab subretinal en pacientes con neovascularización coroidea (CNV) secundaria a degeneración macular relacionada con la edad (AMD). Métodos: Se trataron 4 ojos de cuatro pacientes con CNV subfoveal unilateral avanzada secundaria a AMD, que rechazaron dosis múltiples de bevacizumab intravítreo. Todos los pacientes presentaban una agudeza visual (VA) de 20/400 o peor en el ojo afectado y 20/30 o más en el ojo contralateral. Cada paciente fue sometido a vitrectomía con una única inyección subretinal de bevacizumab (750μg / 0.3ml) y fueron seguidos por un año con exámenes oftalmológicos completos, incluyendo retinofluoresceinografía (FA) y OCT. Resultados: Luego de un año de seguimiento, la VA se mantuvo estable o mejoró en el 100% de los ojos. El grosor macular central (CMT) también disminuyó significativamente y la FA demostró una reducción considerable en el tamaño de las membranas neovasculares subretinales. Conclusiones: Nuestros resultados sugieren que una única dosis de bevacizumab subretinal es segura, efectiva y bien tolerada, y mejora significativamente la VA y el CMT en pacientes con AMD neovascular. Sin embargo, una evaluación a más largo plazo con un seguimiento más extenso y una población mayor es deseable.

Purpose: To determine whether limbal cells have a role In the prevention of recurrence after primary pterygium surgery. Design: Case report series. Participants: 36 eyes with primary pterygium undergoing excision with conjunctival or limbal-conjunctival autograft. Methods: 18 eyes underwent excision with conjunctival autograft, whereas the rest underwent excision with limbal-conjuntival autograft. All of them were followed up for one year. Main Outcome Measure: Recurrence. Results: Two patients in the conjunctival graft group (11%) presented recurrence after 12 months, while none of the patients in the other group had recurrence. However, no statistical difference was found between the two types of autograft. (P = 0.2). Conclusion: The results suggest that the barrier effect of the graft, and not the limbal cells themselves, plays a role in reducing recurrences after primary pterygium surgery. Resumen Objetivo: Determinar si las células límbicas tienen un papel en la prevención de las recidivas tras cirugía del pterigio primario. Diseño: Serie de casos clínicos. Participantes: 36 ojos con pterigio primario sometidos a exéresis asociada a autoinjerto conjuntival o limboconjuntival. Métodos: 18 ojos se sometieron a exéresis con plastia conjuntival, mientras que los restantes se sometieron a exéresis con autoinjerto limboconjuntival. Todos ellos fueron seguidos durante un año. Principal Resultado Medido: Recidiva. Resultados: 2 pacientes en el grupo de plastia conjuntival (11%) presentaban recidiva a los 12 meses, por el contrario ninguno de los pacientes en el otro grupo presentó recidivas. A pesar de esto, no se encontraron diferencias estadísticamente significativas entre ambos tipos de injerto. (P=0.2). Conclusión: Los resultados sugieren que es el efecto barrera del injerto, y no las propias células límbicas, las que tienen un papel en la reducción de las recidivas tras la cirugía del pterigio primario.

The current study illustrates the evolution of the active uveitis found in 15 children two years after initiating treatment; the number of patients in whom the uveitis was treated and controlled; and the duration and the manner of treatment The evolution of other alterations found is also shown including synechiae, capsular opacities, band keratopathy and pathologic cataract, in the same time period. Resumen: En el presente trabajo se muestra la evolución de las uveítis en actividad hallada en estos 15 niños dos años después de iniciado el tratamiento; en cuántos pacientes se logró controlar y hacer desaparecer, en cuánto tiempo y cómo. Se muestra también la evolución de las otras alteraciones que se hallaron tales como sinequias, opacidades capsulares, queratopatía en banda y catarata patológica, en el mismo lapso.

Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) can cause significant damage to the ocular surface and eyelids. The intense inflammation during the acute phase may lead to scarring sequelae and vision loss. Treatment of the chronic manifestations is challenging and only partially effective in many cases. Ophthalmologic evaluation and management during the acute phase is crucial in avoiding these problems. The evaluation and management of patients with SJS and TEN is described, with an emphasis on amniotic membrane transplantation as an effective means of limiting the acute phase damage.